A Retrospective Study to Compare the Efficacy and Postoperative Outcome of Total Hip Arthroplasty with Internal Screw Fixation in Patients with Avascular Necrosis of the Femoral Head.

BACKGROUND This retrospective study compared the effects of total hip arthroplasty (THA) and traditional surgery using internal screw fixation for the treatment of avascular necrosis (AVN) of the femoral head. MATERIAL AND METHODS A total of 270 patients with bilateral ANFH were retrospectively analyzed. Among them, 176 underwent THA (THA group); and 94 underwent closed reduction screw fixation (traditional group).  RESULTS The mean operation time in the traditional surgery group (82.6±15.6 min) was significantly less compared with the THA group (104.8±14.2 min) (P=0.001). Intraoperative blood loss in the traditional surgery group (219.8±21.6 mL) was significantly less compared with the THA group (339.4±29.4 mL) (P=0.001). After treatment, the mean HHS score of the THA group (76.5±9.2 points) was significantly increased when compared with the traditional surgery group (61.4±10.5 points) (P=0.001). Disease recurrence rate in the THA group was significantly reduced compared with the traditional surgery group (P=0.001). The mean quality of life score of the THA group (85.5±6.4 points) was significantly higher than that of the traditional surgery group (73.4±8.8 points) (P=0.001). CONCLUSIONS Compared with closed reduction screw fixation, THA for AVN of the femoral head effectively reduced the length of hospital stay, time to recovery, and achieved an improved clinical outcome.